Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.
It can occur at any age and the earlier the onset, the more serious is the long-term damage, dysfunction and failure of various organs due to the chronic hyperglycemia with diabetes mellitus patients having <10 year in life span compared to non-DM patients.
Type 1 DM patients have complete insulin deficiency due to beta-cell destruction. It may be immune-mediated or idiopathic. More commonly occurs in children 7-15 year of age, but may occur at any age.
Type 2 DM patients have insulin resistance and relative insulin deficiency.
Neonatal DM is hyperglycemia that occurs in the first 6 months of life.

May attempt reducing the dose as soon as recurrent hypoglycemia manifests

Permanent Neonatal DM

DM in the newborn period may be permanent if associated w/ pancreatic agenesis

Studies revealed that almost one-half of neonatal DM patients had permanent diabetes, one third had transient diabetes & about one fourth had transient diabetes that recurred when they were 7-20 years old

Affected twin & families w/ >1 affected infant have been reported

May initially present as euglycemic & w/in the 1st month of life

Maturity-onset diabetes of the young (MODY)

A primary defect in insulin secretion characterized by early onset between 9 & 25 years of age, absence of ketosis & autosomal dominant inheritance

At the development of microalbuminuria, nephropathy may still be reversible

Poor glycemic control, smoking, family history of essential hypertension & cardiovascular disease (CVD) are associated w/ the development of nephropathy

Screen for microalbuminuria annually once the patient starts puberty or is ≥10 years & had DM for 5 years

More frequent testing is indicated w/ increased values

Confirmed elevated albumin-to-creatinine ratio (ACR) (>30 mg/g) consists of 2 out of 3 specimens obtained from separate days over a 6-months interval after treatment initiation for hypo/hyperglycemia & BP for age

Timed overnight or a 24-hours analysis w/ elevated albumin excretion rate (AER) of 20-199 mcg/minute may also be used

Exercise, smoking & menstruation may affect results, confirm on another day

During the Kuala Lumpur International Neonatology Conference held in conjunction with the World Prematurity Day 2017, Dato Dr Musa Mohd Nordin spoke on the importance of immunizing children with the diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine. He highlighted the role of Hexaxim® as a fully liquid, ready-to-use, 6-in-1 (including hepatitis B) vaccine for the primary and booster vaccinations of infants and toddlers. Meanwhile, Dr Yong Junina Fadzil discussed the benefits of quadrivalent influenza vaccines (QIVs) in providing children with broader protection against influenza B viruses.